MoCA-8.3-English-Test-2018-04

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MoCA-8.3-English-Test-2018-04

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Page 1

POINTS

MONTREAL COGNITIVE ASSESSMENT (MoCA ®) Version 8.3 English

NAMING

Name:

Education:

Sex:

Date of birth :

DATE :

Copy bed

Draw CLOCK (Five past ten) (3 points)

[ ] [ ] [ ] [ ] [ ]

/ 5

/ 3

/ 2

/ 1

/ 3

/ 2

/ 1

/ 2

/ 5

/ 6

NO

POINTS

Read list of digits (1 digit / sec.).

Serial 7 subtraction starting at 60.

Repeat: The child walked his dog in the park after midnight.

Language Fluency. Name maximum number of words in one minute that begin with the letter B.

Similarity between e.g. banana - orange = fruit

Category cue

MIS = / 15 Multiple choice cue

Memory

Index Score

(MIS)

Has to recall words

WITH NO CUE

Points for

UNCUED recall only

(MIS)

X3

X2

X1

hammer - screwdriver matches - lamp

The artist finished his painting at the right moment for the exhibition.

LEG

COTTON

SCHOOL

TOMATO

WHITE

Numbers Contour Hands

[ ] [ ] [ ] [ ]

[ ] [ ] [ ]

Read list of words, subject must

repeat them. Do 2 trials, even if 1st trial is successful.

Do a recall after 5 minutes.

MEMORY

ATTENTION

LANGUAGE

ABSTRACTION

DELAYED RECALL

ORIENTATION

LEG

COTTON

SCHOOL

TOMATO

WHITE

1st TRIAL

[ ]

[ ]

Subject has to repeat them in the forward order.

2 4 8 1 5

4 2 7 Subject has to repeat them in the backward order.

[ ]

[

] 53 [ ]

[ ]

[ ]

[ ]

[ ] [ ]

[ ] [ ] [ ]

F B A C M N A A J K L B A F A K D E A A A J A M O F A A B

Read list of letters. The subject must tap with his hand at each letter A. No points if ≥ 2 errors.

4 or 5 correct subtractions: 3 pts, 2 or 3 correct: 2 pts, 1 correct: 1 pt, 0 correct: 0 pt

(N ≥ 11 words)

[ ] Date [ ] Month [ ] Year [ ] Day [ ] Place [ ] City

46 39 32 25

www.mocatest.org

/ 30

TOTAL

© Z. Nasreddine MD

Administered by:

Training and Certification are required to ensure accuracy.

MIS: /15 ( Normal ≥ 26/30)

Add 1 point if ≤ 12 yr education

2nd TRIAL

[ ]

VISUOSPATIAL / EXECUTIVE

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